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[目的]比较儿童肱骨髁上骨折采用两种不同顺序复位的临床效果。[方法]采用前瞻性研究方法,对2008年1月~2010年11月采用切开复位的60例肱骨髁上骨折患儿,随机分成两组,术中分别采用不同的复位顺序进行复位。A组:先复位侧方移位,后复位前后移位;B组:先复位前后移位,后复位侧方移位。直视下观察两种不同顺序复位的效果。对两组患者的解剖复位成功率、获得解剖复位花费的时间及骨折端的稳定性进行比较。[结果]A组30例均在第1次复位取得解剖复位,平均花费时间3 min,25例骨折端稳定,5例不稳定。B组第1次复位6例获得解剖复位,24例失败。失败患者改变复位次序进行第2次复位后均取得解剖复位。获得解剖复位平均花费时间11min。23例骨折断端不稳定,7例稳定。两组资料的第1次解剖复位率、复位花费时间和稳定骨折端所占比例具有显著性差异。[结论]儿童肱骨髁上骨折应当按照先复位侧方移位后复位前后移位的顺序进行复位。
[Objective] To compare the clinical effect of two different sequential reduction of supracondylar humerus fractures in children. [Methods] From January 2008 to November 2010, 60 children with supracondylar fractures of humerus who underwent open reduction were randomly divided into two groups. The patients were respectively treated with different reset procedures. Group A: reset the side of the first shift, after the reset before and after the shift; Group B: before and after the reset shift, reset the side shift. Under direct vision to observe the effect of two different order of reset. The success rate of anatomic reduction, the time spent in anatomic reduction and the stability of the fracture were compared between the two groups. [Result] All the 30 cases in group A got the anatomic reduction on the first reduction, taking an average of 3 minutes. The fracture ends of 25 cases were stable and 5 cases were unstable. In group B, the first reduction was performed in 6 cases, and the anatomic reduction was performed in 24 cases. Failure patients to change the order of reset after the second reset to obtain anatomic reduction. Get an average of 11 min for anatomic reduction. Twenty-three fractures were unstable and 7 were stable. There was a significant difference between the two groups in the first anatomical reduction rate, the time spent in resetting and the proportion of stable fractures. [Conclusion] The supracondylar fractures of the humerus should be reset in the order of displacement before and after the reset of lateral humeral first.